Risk factors for local recurrence of fibromatosis | Revista Española de Cirugía Ortopédica y Traumatología (English Edition)

array:24 ["pii" => "S1988885617300238" "issn" => "19888856" "doi" => "10.1016/j.recote.2017.02.006" "estado" => "S300" "fechaPublicacion" => "2017-03-01" "aid" => "650" "copyright" => "SECOT" "copyrightAnyo" => "2017" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Rev Esp Cir Ortop Traumatol. 2017;61:82-7" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 7 "formatos" => array:2 [ "HTML" => 3 "PDF" => 4 ] ] "Traduccion" => array:1 [ "es" => array:19 [ "pii" => "S188844151730005X" "issn" => "18884415" "doi" => "10.1016/j.recot.2016.12.001" "estado" => "S300" "fechaPublicacion" => "2017-03-01" "aid" => "650" "copyright" => "SECOT" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Rev Esp Cir Ortop Traumatol. 2017;61:82-7" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 54 "formatos" => array:2 [ "HTML" => 46 "PDF" => 8 ] ] "es" => array:13 [ "idiomaDefecto" => true "cabecera" => "ORIGINAL" "titulo" => "Factores de riesgo para la recidiva local de la fibromatosis" "tienePdf" => "es" "tieneTextoCompleto" => "es" "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "82" "paginaFinal" => "87" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Risk factors for local recurrence of fibromatosis" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figura 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1892 "Ancho" => 1625 "Tamanyo" => 110890 ] ] "descripcion" => array:1 [ "es" => "Distribución anatómica." ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "V. Machado, S. Troncoso, L. Mejías, M.Á. Idoate, M. San-Julián" "autores" => array:5 [ 0 => array:2 [ "nombre" => "V." "apellidos" => "Machado" ] 1 => array:2 [ "nombre" => "S." "apellidos" => "Troncoso" ] 2 => array:2 [ "nombre" => "L." "apellidos" => "Mejías" ] 3 => array:2 [ "nombre" => "M.Á." "apellidos" => "Idoate" ] 4 => array:2 [ "nombre" => "M." "apellidos" => "San-Julián" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S1988885617300238" "doi" => "10.1016/j.recote.2017.02.006" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1988885617300238?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S188844151730005X?idApp=UINPBA00004N" "url" => "/18884415/0000006100000002/v1_201703210036/S188844151730005X/v1_201703210036/es/main.assets" ] ] "itemSiguiente" => array:19 [ "pii" => "S1988885617300068" "issn" => "19888856" "doi" => "10.1016/j.recote.2016.11.007" "estado" => "S300" "fechaPublicacion" => "2017-03-01" "aid" => "649" "copyright" => "SECOT" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Rev Esp Cir Ortop Traumatol. 2017;61:88-95" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 5 "formatos" => array:2 [ "HTML" => 3 "PDF" => 2 ] ] "en" => array:12 [ "idiomaDefecto" => true "cabecera" => "Original Article" "titulo" => "Orthogeriatric activity in a general hospital of Castilla-La Mancha, Spain" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "88" "paginaFinal" => "95" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Actividad ortogeriátrica en un hospital general de Castilla-La Mancha" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "J.M. Fernández-Ibáñez, M.C. Morales-Ballesteros, E. Crespo-Romero, S. Gómez-Gómez, M.D. Fraga-Fuentes, J. Cruz-Tejado, P.A. Hernández-Zegarra, Á. Arias-Arias, M.M. García-Baltasar" "autores" => array:9 [ 0 => array:2 [ "nombre" => "J.M." "apellidos" => "Fernández-Ibáñez" ] 1 => array:2 [ "nombre" => "M.C." "apellidos" => "Morales-Ballesteros" ] 2 => array:2 [ "nombre" => "E." "apellidos" => "Crespo-Romero" ] 3 => array:2 [ "nombre" => "S." "apellidos" => "Gómez-Gómez" ] 4 => array:2 [ "nombre" => "M.D." "apellidos" => "Fraga-Fuentes" ] 5 => array:2 [ "nombre" => "J." "apellidos" => "Cruz-Tejado" ] 6 => array:2 [ "nombre" => "P.A." "apellidos" => "Hernández-Zegarra" ] 7 => array:2 [ "nombre" => "Á." "apellidos" => "Arias-Arias" ] 8 => array:2 [ "nombre" => "M.M." "apellidos" => "García-Baltasar" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S1888441517300048" "doi" => "10.1016/j.recot.2016.11.005" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1888441517300048?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1988885617300068?idApp=UINPBA00004N" "url" => "/19888856/0000006100000002/v1_201704050025/S1988885617300068/v1_201704050025/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S1988885617300226" "issn" => "19888856" "doi" => "10.1016/j.recote.2017.02.005" "estado" => "S300" "fechaPublicacion" => "2017-03-01" "aid" => "651" "copyright" => "SECOT" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Rev Esp Cir Ortop Traumatol. 2017;61:70-81" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 5 "formatos" => array:2 [ "HTML" => 3 "PDF" => 2 ] ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "Original article" "titulo" => "A decade of the Catalonian Arthroplasty Register (RACat): Variability, exhaustivity, and survival of prostheses between 2005 and 2014" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "70" "paginaFinal" => "81" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Una década del Registro de Artroplastias de Cataluña (RACat): exhaustividad, variabilidad y supervivencia de las prótesis entre 2005 y 2014" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0020" "etiqueta" => "Figure 4" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr4.jpeg" "Alto" => 1123 "Ancho" => 1566 "Tamanyo" => 89703 ] ] "descripcion" => array:1 [ "en" => "Accumulated incidence of revision in hip arthroplasties caused by arthrosis and facture." ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "J. Arias-de la Torre, A. Capdevila, O. Martínez, L. Domingo, M. Marinelli, N. Robles, J. Nardi, L. Puig-Verdié, F. Pallisó, M. Espallargues" "autores" => array:11 [ 0 => array:2 [ "nombre" => "J." "apellidos" => "Arias-de la Torre" ] 1 => array:2 [ "nombre" => "A." "apellidos" => "Capdevila" ] 2 => array:2 [ "nombre" => "O." "apellidos" => "Martínez" ] 3 => array:2 [ "nombre" => "L." "apellidos" => "Domingo" ] 4 => array:2 [ "nombre" => "M." "apellidos" => "Marinelli" ] 5 => array:2 [ "nombre" => "N." "apellidos" => "Robles" ] 6 => array:2 [ "nombre" => "J." "apellidos" => "Nardi" ] 7 => array:2 [ "nombre" => "L." "apellidos" => "Puig-Verdié" ] 8 => array:2 [ "nombre" => "F." "apellidos" => "Pallisó" ] 9 => array:2 [ "nombre" => "M." "apellidos" => "Espallargues" ] 10 => array:1 [ "colaborador" => "en nombre del Registro de Artroplastias de Cataluña (RACat)" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S1888441517300061" "doi" => "10.1016/j.recot.2017.01.001" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1888441517300061?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1988885617300226?idApp=UINPBA00004N" "url" => "/19888856/0000006100000002/v1_201704050025/S1988885617300226/v1_201704050025/en/main.assets" ] "en" => array:21 [ "idiomaDefecto" => true "cabecera" => "Original Article" "titulo" => "Risk factors for local recurrence of fibromatosis" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "82" "paginaFinal" => "87" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "V. Machado, S. Troncoso, L. Mejías, M.Á. Idoate, M. San-Julián" "autores" => array:5 [ 0 => array:4 [ "nombre" => "V." "apellidos" => "Machado" "email" => array:1 [ 0 => "vmachado@unav.es" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "*" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "S." "apellidos" => "Troncoso" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] ] ] 2 => array:3 [ "nombre" => "L." "apellidos" => "Mejías" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "b" "identificador" => "aff0010" ] ] ] 3 => array:3 [ "nombre" => "M.Á." "apellidos" => "Idoate" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "b" "identificador" => "aff0010" ] ] ] 4 => array:3 [ "nombre" => "M." "apellidos" => "San-Julián" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Departamento de Cirugía Ortopédica y Traumatología, Clínica Universidad de Navarra, Pamplona, Navarra, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Departamento de Anatomía Patológica, Clínica Universidad de Navarra, Pamplona, Navarra, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Factores de riesgo para la recidiva local de la fibromatosis" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1892 "Ancho" => 1625 "Tamanyo" => 112751 ] ] "descripcion" => array:1 [ "en" => "Anatomical distribution." ] ] ] "textoCompleto" => "IntroductionFibromatosis, or desmoid tumour, is a clonal proliferation tumour deriving from mesenchymal cells seated in the fascia and musculoaponeurotic structures. It constitutes a rare group of soft tissue tumours, with an incidence of 2.4–4.3 new cases per 106 inhabitants/year.<a class="elsevierStyleCrossRefs" href="#bib0075">1–3</a>For many years, this tumour was treated by surgery fundamentally, reserving chemotherapy, radiotherapy and other systemic treatments such as tamoxifen or more recently, imatinib or toremifine,<a class="elsevierStyleCrossRefs" href="#bib0080">2,4</a> for cases with positive surgical margins to improve local control of the disease.<a class="elsevierStyleCrossRef" href="#bib0075">1</a>It can appear in practically any part of the body<a class="elsevierStyleCrossRefs" href="#bib0095">5,6</a> and is locally aggressive, with a high local recurrence rate, despite broad surgical resection, although it lacks the capacity for remote metastasis.<a class="elsevierStyleCrossRef" href="#bib0080">2</a>Conservative management has been proposed recently as an acceptable treatment option, since it is not unusual for the tumour to stop growing spontaneously. This would prevent functional complications and post-radiation effects associated with the conventional, radical management of fibromatosis.<a class="elsevierStyleCrossRef" href="#bib0075">1</a>Because this is a rare entity, the series available in the literature enable us to establish a consensus on some of the factors that influence the natural evolution of the disease. It is our intention to evaluate the data that might predict local recurrence.MethodsWe undertook a retrospective study identifying 192 patients with an anatomopathological diagnosis of fibromatosis in our institution from 1983 to 2014. Patients with a clinical diagnosis of Dupuytren's, Ledderhose disease or intra-abdominal desmoid tumour were excluded from the study, because their prognosis is more favourable, and patients with an unclear final diagnosis.The following variables were gathered from the patients included in the study: age at the time of diagnosis, gender, imaging test type used in diagnosis, location, tumour size and depth, relation to the vascular bundle, initial treatment given, primary tumour resection margins, recurrences, time until recurrence, treatment and surgical margins, and finally, follow-up time and the patients’ current condition and functional status according to the Musculoskeletal Tumour Society Score. Due to the wide range of years over which our patients were diagnosed, we also gathered the variations in the type of treatment through that time.All our cases were identified initially as primary or recurrences as they presented in our centre. However, this difference was not taken into account in the statistical analysis for classifying the primary tumours or recurrences, or the subsequent determination of risk factors.The statistical analysis was then undertaken using the χ2 test to assess the influence of patient gender, age, depth, size, location, surgical margins and initial treatment on local recurrences.For this analysis, in terms of age, the patients aged ≤30 years were classified as “young” and those aged >30 years as “older”. Tumours that measured <5cm were classified as “small” and those that measured ≥5cm as “large”, in the same way as soft-tissue sarcomas. Finally, the tumour location was divided into 2 large groups: extremities and trunk, the latter included neck, breast, chest wall, abdominal wall and paravertebrals.The initial treatment of our patients was evaluated. Most underwent surgery as single therapy. Some cases received adjuvant treatment as well as surgery, such as radiotherapy, chemotherapy and tamoxifen.The resection margins were classified according to Enneking's criteria. In addition, a revision of the histological preparations was made to quantify the Ki-67 of the histological blocks from 1992 onwards.ResultsOur series includes 51 patients with a clinical and anatomopathological diagnosis of fibromatosis. Twenty-nine of these patients were treated primarily in our centre, and 22 presented as recurrences.The mean follow-up was 83 months (range 6–240 months).The most common anatomical distribution was tumours located in the extremities (n=38) compared to the trunk (n=13) (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>).<elsevierMultimedia ident="fig0005"></elsevierMultimedia>The mean age at time of diagnosis was 26 years, with a range from 2 to 68 years. Distribution by gender showed a slight male predominance, unlike the other published series.The mean size, measured as the maximum tumour diameter, was 9.9cm (range 3–31cm). Most of the tumours were found deep in the fascia. The imaging test used to study the tumours was initially ultrasound. From 1990 onwards, diagnosis was made by magnetic resonance.A complete macroscopic and microscopic (R0) resection was achieved in 11 patients. The margins were microscopically positive (R1) in 16 patients, and in 11 cases, the resection was intentionally incomplete on entry (R2) due, principally, to the great morbidity resulting from radical surgery in certain locations such as the popliteal fossa, groin and axilla. We have no information on the outcomes of the resection margins of the primary tumour for 13 patients (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>).<elsevierMultimedia ident="tbl0005"></elsevierMultimedia>In our patients, the proliferation rate, quantified using Ki-67, was a mean 1.9% (range 1–4).The total number of recurrences in our series was 37, including incident cases (n=15) plus those that presented as recurrences in our institution (n=22). Out of these, 22 presented new recurrences (n=7 and n=15, respectively). The incidence of “re-recurrence” was less in the cases treated primarily in our centre (46.7% vs 68.2%), although this difference is not statistically significant (p=0.443). Neither are there statistically significant differences in re-recurrences according to the treatment of the first recurrence (p=0.112).The mean time between the primary resection and the first recurrence was 32 month (range 2–420 months), although recurrence within the first year (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>) was most frequent. The mean time until repeat recurrence is similar to that of the first (mean 22.56, range 2–42).<elsevierMultimedia ident="fig0010"></elsevierMultimedia>Due to the limited number of cases treated with adjuvant therapies, no clear pattern for choosing this treatment was established. However, we did observe a variation over the years in terms of the type of radiotherapy. Up until 1999, patients who underwent radiotherapy received intraoperative radiotherapy complemented later with external radiotherapy, whereas from 1999 onwards brachytherapy plus external radiotherapy was used. In both groups, the mean dose received was 45Gy, and in no case did this exceed 60Gy.We saw no homogeneity in terms of chemotherapy protocol either (<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>).<elsevierMultimedia ident="tbl0010"></elsevierMultimedia>Twenty-seven patients are currently disease-free, 8 are in the progression phase, 15 are in stable disease phase, and for one patient we have no information.We observed no statistically significant differences in our series with regard to gender, age, size, margins or initial treatment as risk factors for local recurrence. By contrast, we did observe a greater risk of local recurrence in patients presenting tumours deep in the fascia (p=0.003) and tumours located in the extremities (p<0.0001) (<a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>).<elsevierMultimedia ident="tbl0015"></elsevierMultimedia>The Musculoskeletal Tumour Society Score showed no statistically significant differences either (p=0.19) between the patients treated with surgery alone compared to those treated with surgery plus radiotherapy and those who underwent follow-up with periodic monitoring. Other complications after surgery included lymphoedema (n=2) and paralysis of the peroneal nerve (n=1).DiscussionIn most current studies, positive surgical margins are considered a risk factor of local recurrence; however, there is no universal consensus on the matter.<a class="elsevierStyleCrossRefs" href="#bib0085">3,6–8</a> In our case, we found no statistically significant differences in this parameter.Although there is no unanimity in this regard, the negative effect of incomplete surgery with positive margins (R1, R2) on local recurrence of the disease has a strong biological basis.<a class="elsevierStyleCrossRef" href="#bib0115">9</a> Up to 75% of desmoid tumours present mutations associated with β-catenin. Most are sporadic, although a small percentage is associated with APC gene mutations, in Gardner syndrome.<a class="elsevierStyleCrossRefs" href="#bib0075">1,10,11</a>In the initial phase of wound healing, growth factors are released that activate β-catenin. This protein plays an important role in healing, since it stimulates the proliferation of fibroblasts, and therefore is also important in fibroproliferative disorders. Incomplete resection of a tumour involves leaving genetically altered cells in the bed exposed to the healing mechanisms of the tissues. Thus, surgery itself acts as a cancer potentiator in cases where there is a beta-catenin aberration.Various mutations have been identified in the CTNNB1 gene, responsible for coding β-catenin. The mutations of this gene that are associated with fibromatosis are T41A, S45F and 45P, but S45F is the only one of prognostic value as a predictor of local recurrence.<a class="elsevierStyleCrossRef" href="#bib0130">12</a> These variations in β-catenin mutations can in part explain the differences in the development of recurrences in relation to surgical margins.<a class="elsevierStyleCrossRefs" href="#bib0075">1,8,12</a>As we have seen to date, the evolution of this tumour is unpredictable, up to a certain point. In many cases, there is a high tendency for local recurrence despite apparently complete resection. Furthermore, some studies support the fact that adjuvant therapies can be effective in controlling the disease. However, there is no consensus in this regard, since there are desmoid tumours that have been observed to stop growing spontaneously.<a class="elsevierStyleCrossRefs" href="#bib0085">3,7,13,14</a> It does appear clear that as we increase therapeutic measures, in addition to increasing monitoring of the disease, we enhance the functional consequences, those of radical surgery and radiotherapy in particular.<a class="elsevierStyleCrossRefs" href="#bib0135">13,14</a>We must remember, in our series, that treatment by periodic monitoring only took place in patients who had already developed local recurrence, therefore we do not know what would have happened if we had not operated the primary tumours.In high grade tumours, when we observe multiple recurrences, the disease-free time between each recurrence progressively shortens. In desmoid tumours, recurrences do not follow this pattern. As we saw in our series, the recurrences, both primary and secondary, occurred most frequently during the first year, without the disease-free time between the first and the second recurrence being significantly shortened.Due to the lack of evidence in our series on the efficacy of the various treatments on local control of the disease, we cannot actively recommend the use of radiotherapy, chemotherapy or tamoxifen as adjuvant treatment.It was observed that in selected cases, where the tumour was asymptomatic and did not display aggressive behaviour throughout follow-up, conservative treatment by periodic monitoring achieved local control of the disease at 3 years similar to that of the patients who underwent complete resection (R0).<a class="elsevierStyleCrossRefs" href="#bib0075">1,3,7</a>Due to the high rate of local recurrence and the morbidity after multiple surgeries, a wait-and-see approach should be considered for all desmoid tumours, primary or recurrences, which are asymptomatic and have not grown throughout their evolution.Level of evidenceLevel of evidence III.Ethical disclosuresProtection of people and animalsThe authors declare that no experiments were performed on humans or animals for this study.Confidentiality of dataThe authors declare that they have followed the protocols of their centre of work regarding the publication of patient data.Right to privacy and informed consentThe authors declare that no patient data appear in this article.Conflict of interestsThe authors have no conflict of interests to declare." "textoCompletoSecciones" => array:1 [ "secciones" => array:13 [ 0 => array:3 [ "identificador" => "xres824432" "titulo" => "Abstract" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Objective" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Discussion" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec820938" "titulo" => "Keywords" ] 2 => array:3 [ "identificador" => "xres824433" "titulo" => "Resumen" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Objetivo" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Métodos" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Discusión" ] ] ] 3 => array:2 [ "identificador" => "xpalclavsec820937" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 5 => array:2 [ "identificador" => "sec0010" "titulo" => "Methods" ] 6 => array:2 [ "identificador" => "sec0015" "titulo" => "Results" ] 7 => array:2 [ "identificador" => "sec0020" "titulo" => "Discussion" ] 8 => array:2 [ "identificador" => "sec0025" "titulo" => "Level of evidence" ] 9 => array:3 [ "identificador" => "sec0030" "titulo" => "Ethical disclosures" "secciones" => array:3 [ 0 => array:2 [ "identificador" => "sec0035" "titulo" => "Protection of people and animals" ] 1 => array:2 [ "identificador" => "sec0040" "titulo" => "Confidentiality of data" ] 2 => array:2 [ "identificador" => "sec0045" "titulo" => "Right to privacy and informed consent" ] ] ] 10 => array:2 [ "identificador" => "sec0050" "titulo" => "Conflict of interests" ] 11 => array:2 [ "identificador" => "xack276488" "titulo" => "Acknowledgements" ] 12 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2016-06-02" "fechaAceptado" => "2016-12-10" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec820938" "palabras" => array:4 [ 0 => "Fibromatosis" 1 => "Desmoid tumour" 2 => "Local recurrence" 3 => "Risk factors" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec820937" "palabras" => array:4 [ 0 => "Fibromatosis" 1 => "Tumor desmoide" 2 => "Recidiva local" 3 => "Factores de riesgo" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:3 [ "titulo" => "Abstract" "resumen" => "ObjectiveTo evaluate the clinical, radiological and histological factors that can predict local recurrence of fibromatosis. MethodsA retrospective study was conducted on 51 patients diagnosed with fibromatosis in this hospital from 1983 to 2014. The mean follow-up was 83 months. A study was made of the clinical parameters, location, depth, size, surgical margins, and proliferation index (Ki-67). An evaluation was also made of the risk of recurrence depending on the adjuvant treatment and the relationship between treatment and patient functionality. ResultsTumour location and depth were identified as risk factors for local recurrence, showing statistically significant differences (P<.001 and P=.003, respectively). There were no statistically significant differences in age, gender, size, surgical margins, or adjuvant treatments, or in the Musculoskeletal Tumour Society Score according to the treatment received. The mean Ki-67 was 1.9% (range 1–4), and its value was not associated with the risk of recurrence. DiscussionDeep fibromatosis fascia tumours, and those located in extremities are more aggressive than superficial tumours and those located in trunk. The Ki-67 has no predictive value in local recurrence of fibromatosis. Radiotherapy, chemotherapy, or other adjuvant treatments such as tamoxifen have not been effective in local control of the disease. Given the high recurrence rate, even with adequate margins, a wait and see attitude should be considered in asymptomatic patients and/or stable disease." "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Objective" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Discussion" ] ] ] "es" => array:3 [ "titulo" => "Resumen" "resumen" => "ObjetivoValorar los factores clínicos, radiológicos e histológicos que pueden predecir la recidiva local de fibromatosis. MétodosHemos realizado un estudio retrospectivo de 51 pacientes con diagnóstico de fibromatosis en nuestra institución desde 1983 hasta 2014. La media de seguimiento es de 83 meses. Hemos estudiado parámetros clínicos, localización, profundidad, tamaño, márgenes quirúrgicos e índice de proliferación (Ki-67) del tumor. Asimismo, hemos valorado el riesgo de recidiva en función del tratamiento adyuvante y la relación del tratamiento con la funcionalidad del paciente. ResultadosHemos observado diferencias estadísticamente significativas en cuanto a la profundidad (p=0,003) y la localización (p<0,001) como factores de riesgo de recidiva local. No existen diferencias estadísticamente significativas en cuanto a edad, sexo, tamaño, márgenes quirúrgicos ni tratamientos adyuvantes, ni en el Musculoskeletal Tumor Society Score en función del tratamiento recibido. El Ki-67 tiene una media de 1,9% (rango 1-4) y su valor no se asocia con el riesgo de recidiva. DiscusiónLos tumores profundos a la fascia y los localizados en extremidades son más agresivos que los localizados superficialmente y en el tronco. El Ki-67 no tiene valor predictivo en las recidivas de la fibromatosis. La radioterapia, la quimioterapia u otros tratamientos adyuvantes como el tamoxifeno no han sido eficaces en el control local de la enfermedad. La gran cantidad de recidivas, incluso en pacientes con resecciones adecuadas, induce a plantear la posibilidad de una actitud expectante en tumores asintomáticos o en enfermedad estable." "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Objetivo" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Métodos" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Discusión" ] ] ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "Please cite this article as: Machado V, Troncoso S, Mejías L, Idoate MÁ, San-Julián M. Factores de riesgo para la recidiva local de la fibromatosis. Rev Esp Cir Ortop Traumatol. 2017;61:82–87." ] ] "multimedia" => array:5 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1892 "Ancho" => 1625 "Tamanyo" => 112751 ] ] "descripcion" => array:1 [ "en" => "Anatomical distribution." ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1846 "Ancho" => 1583 "Tamanyo" => 67905 ] ] "descripcion" => array:1 [ "en" => "Time since first local recurrence." ] ] 2 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at1" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "leyenda" => "NA: not available; CT: chemotherapy; RT: radiotherapy." "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="" valign="top" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">n \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">% \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry " colspan="3" align="left" valign="top">Gender</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Male \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">28 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">45.1 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Female \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">23 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">54.9 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="3" align="left" valign="top"></td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="3" align="left" valign="top">Depth</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Superficial \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">17.6 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Deep \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">41 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">80.4 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="3" align="left" valign="top"></td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="3" align="left" valign="top">Size</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><5cm \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">7.8 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">≥5cm \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">47 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">92.2 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="3" align="left" valign="top"></td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="3" align="left" valign="top">Relation with vascular bundle</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">17.7 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">17 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">33.3 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">25 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">49 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="3" align="left" valign="top"></td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="3" align="left" valign="top">Treatment of primary tumour</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Surgery \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">40 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">78.4 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Surgery+RT \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">17.6 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Surgery+CT \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Surgery+RT+tamoxifen \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="3" align="left" valign="top"></td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="3" align="left" valign="top">Primary resection margins</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">R0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">11 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">21.6 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">R1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">16 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">31.4 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">R2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">11 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">21.5 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">13 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">25.5 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="3" align="left" valign="top"></td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="3" align="left" valign="top">Local recurrence</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">13 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">25.5 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">37 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">72.5 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1386111.png" ] ] ] ] "descripcion" => array:1 [ "en" => "Characteristics of the patients with fibromatosis and of the primary tumour." ] ] 3 => array:8 [ "identificador" => "tbl0010" "etiqueta" => "Table 2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at2" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "leyenda" => "VAC: vincristine+doxorubicin+cyclophosphamide." "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Patient \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Protocol \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Year \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Case 8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">VAC+methotrexate+ribervin+etoposide \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1991 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Case 14 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Vincristine+actinomycin D+cyclophosphamide \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2004 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Case 28 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Adriamycin+cisplatin \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2008 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Case 32 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Imatinib \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2008 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Case 33 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Bevacizumab \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2007 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1386112.png" ] ] ] ] "descripcion" => array:1 [ "en" => "Protocols of chemotherapy administered." ] ] 4 => array:8 [ "identificador" => "tbl0015" "etiqueta" => "Table 3" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at3" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "leyenda" => "The statistically significant p value results are in bold." "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="" valign="top" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">χ2 \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">p \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Gender \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.84 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.66 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Age \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2.37 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.31 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Depth \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">9.11 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.003 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Size \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.30 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.25 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Location \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">16.01 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Margins \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">12.14 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.059 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Initial treatment \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2.51 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.86 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1386113.png" ] ] ] ] "descripcion" => array:1 [ "en" => "Risk factors for local recurrence." ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:14 [ 0 => array:3 [ "identificador" => "bib0075" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Extra-abdominal primary fibromatosis: aggressive management could be avoided in a subgroup of patients" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "S. Bonvalot" 1 => "H. Eldweny" 2 => "V. Haddad" 3 => "F. Rimareix" 4 => "G. Missernad" 5 => "O. Oberlin" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.ejso.2007.06.006" "Revista" => array:6 [ "tituloSerie" => "Eur J Surg Oncol" "fecha" => "2008" "volumen" => "34" "paginaInicial" => "462" "paginaFinal" => "468" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17709227" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0080" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Management of sporadic desmoid-type fibromatosis: a European consensus approach based on patients’ and professionals’ expertise – a Sarcoma Patients EuroNet and European Organisation for Research and Treatment of Cancer/Soft Tissue and Bone Sarcoma Group initiative" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "B. Kasper" 1 => "C. Baumgarten" 2 => "S. Bonvalot" 3 => "R. Haas" 4 => "F. Haller" 5 => "P. Hohenberger" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.ejca.2014.11.005" "Revista" => array:6 [ "tituloSerie" => "Eur J Cancer" "fecha" => "2015" "volumen" => "51" "paginaInicial" => "127" "paginaFinal" => "136" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25434922" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0085" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Prognostic factors influencing event-free survival and treatments in desmoid-type fibromatosis: analysis from a large institution" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "K. Huang" 1 => "C. Wang" 2 => "J. Chen" 3 => "C.Y. Du" 4 => "Y. Zhou" 5 => "Y. Shi" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.amjsurg.2013.08.007" "Revista" => array:6 [ "tituloSerie" => "Am J Surg" "fecha" => "2014" "volumen" => "207" "paginaInicial" => "847" "paginaFinal" => "854" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24119719" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0090" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Hormonal manipulation with toremifene in sporadic desmoid-type fibromatosis" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M. Fiore" 1 => "C. Colombo" 2 => "S. Radaelli" 3 => "D. Callegaro" 4 => "E. Palassini" 5 => "M. Barisella" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.ejca.2015.08.026" "Revista" => array:6 [ "tituloSerie" => "Eur J Cancer" "fecha" => "2015" "volumen" => "51" "paginaInicial" => "2800" "paginaFinal" => "2807" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26602014" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0095" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Local recurrence after surgery for primary extra-abdominal desmoid-type fibromatosis" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "D.L. Van Broekhoven" 1 => "C. Verhoef" 2 => "S.G. Elias" 3 => "A.J. Witkamp" 4 => "J.M. van Gorp" 5 => "B.A. van Geel" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1002/bjs.9194" "Revista" => array:6 [ "tituloSerie" => "Br J Surg" "fecha" => "2013" "volumen" => "100" "paginaInicial" => "1214" "paginaFinal" => "1219" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23804156" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0100" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Desmoid tumor: analysis of prognostic factors and outcomes in a surgical series" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J.T. Mullen" 1 => "T.F. DeLaney" 2 => "W.K. Kobayashi" 3 => "J. Szymonifka" 4 => "B.Y. Yeap" 5 => "Y.L. Chen" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1245/s10434-012-2638-2" "Revista" => array:6 [ "tituloSerie" => "Ann Surg Oncol" "fecha" => "2012" "volumen" => "19" "paginaInicial" => "4028" "paginaFinal" => "4035" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22965569" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0105" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Recurrence and prognostic factors in patients with aggressive fibromatosis. The role of radical surgery and its limitations" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "E. Bertani" 1 => "A. Testori" 2 => "A. Chiappa" 3 => "P. Misitano" 4 => "R. Biffi" 5 => "G. Viale" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1186/1477-7819-10-184" "Revista" => array:5 [ "tituloSerie" => "World J Surg Oncol" "fecha" => "2012" "volumen" => "10" "paginaInicial" => "184" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22963172" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0110" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Actualisation de la stratégie thérapeutique locorégionale dans les sarcomes des tissus mous et les tumeurs desmoids des membres" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "S. Bonvalot" 1 => "F. Rimareix" 2 => "A. Paumier" 3 => "E. Roberti" 4 => "H. Bouzaiene" 5 => "C. Le Péchoux" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.canrad.2010.06.016" "Revista" => array:6 [ "tituloSerie" => "Cancer Radiother" "fecha" => "2010" "volumen" => "14" "paginaInicial" => "455" "paginaFinal" => "459" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20797892" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0115" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "β-Catenin mutation status and outcomes in sporadic desmoid tumors" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J. Mullen" 1 => "T. Delaney" 2 => "A. Rosenberg" 3 => "L. Le" 4 => "J. Iafrate" 5 => "W. Kobayashi" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1634/theoncologist.2012-0449" "Revista" => array:6 [ "tituloSerie" => "Oncologist" "fecha" => "2013" "volumen" => "18" "paginaInicial" => "1043" "paginaFinal" => "1049" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23960186" "web" => "Medline" ] ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0120" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A prognostic nomogram for prediction of recurrence in desmoid fibromatosis" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "A.M. Crago" 1 => "B. Denton" 2 => "S. Salas" 3 => "A. Dufresne" 4 => "J.J. Mezhir" 5 => "M. Hameed" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/SLA.0b013e31828c8a30" "Revista" => array:6 [ "tituloSerie" => "Ann Surg" "fecha" => "2013" "volumen" => "258" "paginaInicial" => "347" "paginaFinal" => "353" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23532110" "web" => "Medline" ] ] ] ] ] ] ] ] 10 => array:3 [ "identificador" => "bib0125" "etiqueta" => "11" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Desmoid-type fibromatosis-associated gardner fibromas: prevalence and impact on local recurrence" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "J. Cates" 1 => "T. Stricker" 2 => "D. Sturgeon" 3 => "C. Coffin" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.canlet.2014.07.020" "Revista" => array:6 [ "tituloSerie" => "Cancer Lett" "fecha" => "2014" "volumen" => "353" "paginaInicial" => "176" "paginaFinal" => "181" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25064609" "web" => "Medline" ] ] ] ] ] ] ] ] 11 => array:3 [ "identificador" => "bib0130" "etiqueta" => "12" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Prognostic value of CTNNB1 gene mutation in primary sporadic aggressive fibromatosis" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "D.L. Van Broekhoven" 1 => "C. Verhoef" 2 => "D. Grünhagen" 3 => "J. van Gorp" 4 => "M. den Bakker" 5 => "J. Hinrichs" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1245/s10434-014-4156-x" "Revista" => array:6 [ "tituloSerie" => "Ann Surg Oncol" "fecha" => "2014" "volumen" => "22" "paginaInicial" => "1464" "paginaFinal" => "1470" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25341748" "web" => "Medline" ] ] ] ] ] ] ] ] 12 => array:3 [ "identificador" => "bib0135" "etiqueta" => "13" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Surgical resection and radiation therapy of desmoid tumours of the extremities: results of a supra-regional tumour centre" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "P. Prodinger" 1 => "H. Rechl" 2 => "M. Keller" 3 => "H. Pilge" 4 => "M. Salzmann" 5 => "R. von Eisenhart-Rothe" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "SICOT J" "fecha" => "2013" "volumen" => "37" "paginaInicial" => "1987" "paginaFinal" => "1993" ] ] ] ] ] ] 13 => array:3 [ "identificador" => "bib0140" "etiqueta" => "14" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The desmoid tumour: local control after surgical treatment" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "H.R. Ihalainen" 1 => "V. Koljonen" 2 => "T.O. Böhling" 3 => "E.J. Tukiainen" 4 => "M.M. Sampo" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3109/2000656X.2014.920710" "Revista" => array:6 [ "tituloSerie" => "J Plast Surg Hand Surg" "fecha" => "2015" "volumen" => "49" "paginaInicial" => "19" "paginaFinal" => "24" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25116575" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] "agradecimientos" => array:1 [ 0 => array:4 [ "identificador" => "xack276488" "titulo" => "Acknowledgements" "texto" => "To Dr. Juan Pons de Villanueva and Dr. Dámaso Aquerreta." "vista" => "all" ] ] ] "idiomaDefecto" => "en" "url" => "/19888856/0000006100000002/v1_201704050025/S1988885617300238/v1_201704050025/en/main.assets" "Apartado" => array:4 [ "identificador" => "7577" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Original articles" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/19888856/0000006100000002/v1_201704050025/S1988885617300238/v1_201704050025/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1988885617300238?idApp=UINPBA00004N"]

Statistics

Original Article

Risk factors for local recurrence of fibromatosis

Factores de riesgo para la recidiva local de la fibromatosis

V. Machadoa,

Corresponding author

vmachado@unav.es

Corresponding author.

, S. Troncosoa, L. Mejíasb, M.Á. Idoateb, M. San-Juliána

a Departamento de Cirugía Ortopédica y Traumatología, Clínica Universidad de Navarra, Pamplona, Navarra, Spain

b Departamento de Anatomía Patológica, Clínica Universidad de Navarra, Pamplona, Navarra, Spain

Read

1369

Times
was read the article

293

Total PDF

1076

Total HTML

Share statistics

 array:24 [
  "pii" => "S1988885617300238"
  "issn" => "19888856"
  "doi" => "10.1016/j.recote.2017.02.006"
  "estado" => "S300"
  "fechaPublicacion" => "2017-03-01"
  "aid" => "650"
  "copyright" => "SECOT"
  "copyrightAnyo" => "2017"
  "documento" => "article"
  "crossmark" => 1
  "subdocumento" => "fla"
  "cita" => "Rev Esp Cir Ortop Traumatol. 2017;61:82-7"
  "abierto" => array:3 [
    "ES" => false
    "ES2" => false
    "LATM" => false
  ]
  "gratuito" => false
  "lecturas" => array:2 [
    "total" => 7
    "formatos" => array:2 [
      "HTML" => 3
      "PDF" => 4
    ]
  ]
  "Traduccion" => array:1 [
    "es" => array:19 [
      "pii" => "S188844151730005X"
      "issn" => "18884415"
      "doi" => "10.1016/j.recot.2016.12.001"
      "estado" => "S300"
      "fechaPublicacion" => "2017-03-01"
      "aid" => "650"
      "copyright" => "SECOT"
      "documento" => "article"
      "crossmark" => 1
      "subdocumento" => "fla"
      "cita" => "Rev Esp Cir Ortop Traumatol. 2017;61:82-7"
      "abierto" => array:3 [
        "ES" => false
        "ES2" => false
        "LATM" => false
      ]
      "gratuito" => false
      "lecturas" => array:2 [
        "total" => 54
        "formatos" => array:2 [
          "HTML" => 46
          "PDF" => 8
        ]
      ]
      "es" => array:13 [
        "idiomaDefecto" => true
        "cabecera" => "<span class="elsevierStyleTextfn">ORIGINAL</span>"
        "titulo" => "Factores de riesgo para la recidiva local de la fibromatosis"
        "tienePdf" => "es"
        "tieneTextoCompleto" => "es"
        "tieneResumen" => array:2 [
          0 => "es"
          1 => "en"
        ]
        "paginas" => array:1 [
          0 => array:2 [
            "paginaInicial" => "82"
            "paginaFinal" => "87"
          ]
        ]
        "titulosAlternativos" => array:1 [
          "en" => array:1 [
            "titulo" => "Risk factors for local recurrence of fibromatosis"
          ]
        ]
        "contieneResumen" => array:2 [
          "es" => true
          "en" => true
        ]
        "contieneTextoCompleto" => array:1 [
          "es" => true
        ]
        "contienePdf" => array:1 [
          "es" => true
        ]
        "resumenGrafico" => array:2 [
          "original" => 0
          "multimedia" => array:7 [
            "identificador" => "fig0005"
            "etiqueta" => "Figura 1"
            "tipo" => "MULTIMEDIAFIGURA"
            "mostrarFloat" => true
            "mostrarDisplay" => false
            "figura" => array:1 [
              0 => array:4 [
                "imagen" => "gr1.jpeg"
                "Alto" => 1892
                "Ancho" => 1625
                "Tamanyo" => 110890
              ]
            ]
            "descripcion" => array:1 [
              "es" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Distribuci&#243;n anat&#243;mica&#46;</p>"
            ]
          ]
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "V&#46; Machado, S&#46; Troncoso, L&#46; Mej&#237;as, M&#46;&#193;&#46; Idoate, M&#46; San-Juli&#225;n"
            "autores" => array:5 [
              0 => array:2 [
                "nombre" => "V&#46;"
                "apellidos" => "Machado"
              ]
              1 => array:2 [
                "nombre" => "S&#46;"
                "apellidos" => "Troncoso"
              ]
              2 => array:2 [
                "nombre" => "L&#46;"
                "apellidos" => "Mej&#237;as"
              ]
              3 => array:2 [
                "nombre" => "M&#46;&#193;&#46;"
                "apellidos" => "Idoate"
              ]
              4 => array:2 [
                "nombre" => "M&#46;"
                "apellidos" => "San-Juli&#225;n"
              ]
            ]
          ]
        ]
      ]
      "idiomaDefecto" => "es"
      "Traduccion" => array:1 [
        "en" => array:9 [
          "pii" => "S1988885617300238"
          "doi" => "10.1016/j.recote.2017.02.006"
          "estado" => "S300"
          "subdocumento" => ""
          "abierto" => array:3 [
            "ES" => false
            "ES2" => false
            "LATM" => false
          ]
          "gratuito" => false
          "lecturas" => array:1 [
            "total" => 0
          ]
          "idiomaDefecto" => "en"
          "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1988885617300238?idApp=UINPBA00004N"
        ]
      ]
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S188844151730005X?idApp=UINPBA00004N"
      "url" => "/18884415/0000006100000002/v1_201703210036/S188844151730005X/v1_201703210036/es/main.assets"
    ]
  ]
  "itemSiguiente" => array:19 [
    "pii" => "S1988885617300068"
    "issn" => "19888856"
    "doi" => "10.1016/j.recote.2016.11.007"
    "estado" => "S300"
    "fechaPublicacion" => "2017-03-01"
    "aid" => "649"
    "copyright" => "SECOT"
    "documento" => "article"
    "crossmark" => 1
    "subdocumento" => "fla"
    "cita" => "Rev Esp Cir Ortop Traumatol. 2017;61:88-95"
    "abierto" => array:3 [
      "ES" => false
      "ES2" => false
      "LATM" => false
    ]
    "gratuito" => false
    "lecturas" => array:2 [
      "total" => 5
      "formatos" => array:2 [
        "HTML" => 3
        "PDF" => 2
      ]
    ]
    "en" => array:12 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Original Article</span>"
      "titulo" => "Orthogeriatric activity in a general hospital of Castilla-La Mancha&#44; Spain"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "tieneResumen" => array:2 [
        0 => "en"
        1 => "es"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "88"
          "paginaFinal" => "95"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Actividad ortogeri&#225;trica en un hospital general de Castilla-La Mancha"
        ]
      ]
      "contieneResumen" => array:2 [
        "en" => true
        "es" => true
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "J&#46;M&#46; Fern&#225;ndez-Ib&#225;&#241;ez, M&#46;C&#46; Morales-Ballesteros, E&#46; Crespo-Romero, S&#46; G&#243;mez-G&#243;mez, M&#46;D&#46; Fraga-Fuentes, J&#46; Cruz-Tejado, P&#46;A&#46; Hern&#225;ndez-Zegarra, &#193;&#46; Arias-Arias, M&#46;M&#46; Garc&#237;a-Baltasar"
          "autores" => array:9 [
            0 => array:2 [
              "nombre" => "J&#46;M&#46;"
              "apellidos" => "Fern&#225;ndez-Ib&#225;&#241;ez"
            ]
            1 => array:2 [
              "nombre" => "M&#46;C&#46;"
              "apellidos" => "Morales-Ballesteros"
            ]
            2 => array:2 [
              "nombre" => "E&#46;"
              "apellidos" => "Crespo-Romero"
            ]
            3 => array:2 [
              "nombre" => "S&#46;"
              "apellidos" => "G&#243;mez-G&#243;mez"
            ]
            4 => array:2 [
              "nombre" => "M&#46;D&#46;"
              "apellidos" => "Fraga-Fuentes"
            ]
            5 => array:2 [
              "nombre" => "J&#46;"
              "apellidos" => "Cruz-Tejado"
            ]
            6 => array:2 [
              "nombre" => "P&#46;A&#46;"
              "apellidos" => "Hern&#225;ndez-Zegarra"
            ]
            7 => array:2 [
              "nombre" => "&#193;&#46;"
              "apellidos" => "Arias-Arias"
            ]
            8 => array:2 [
              "nombre" => "M&#46;M&#46;"
              "apellidos" => "Garc&#237;a-Baltasar"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "es" => array:9 [
        "pii" => "S1888441517300048"
        "doi" => "10.1016/j.recot.2016.11.005"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => false
          "ES2" => false
          "LATM" => false
        ]
        "gratuito" => false
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "es"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1888441517300048?idApp=UINPBA00004N"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1988885617300068?idApp=UINPBA00004N"
    "url" => "/19888856/0000006100000002/v1_201704050025/S1988885617300068/v1_201704050025/en/main.assets"
  ]
  "itemAnterior" => array:19 [
    "pii" => "S1988885617300226"
    "issn" => "19888856"
    "doi" => "10.1016/j.recote.2017.02.005"
    "estado" => "S300"
    "fechaPublicacion" => "2017-03-01"
    "aid" => "651"
    "copyright" => "SECOT"
    "documento" => "article"
    "crossmark" => 1
    "subdocumento" => "fla"
    "cita" => "Rev Esp Cir Ortop Traumatol. 2017;61:70-81"
    "abierto" => array:3 [
      "ES" => false
      "ES2" => false
      "LATM" => false
    ]
    "gratuito" => false
    "lecturas" => array:2 [
      "total" => 5
      "formatos" => array:2 [
        "HTML" => 3
        "PDF" => 2
      ]
    ]
    "en" => array:13 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Original article</span>"
      "titulo" => "A decade of the Catalonian Arthroplasty Register &#40;RACat&#41;&#58; Variability&#44; exhaustivity&#44; and survival of prostheses between 2005 and 2014"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "tieneResumen" => array:2 [
        0 => "en"
        1 => "es"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "70"
          "paginaFinal" => "81"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Una d&#233;cada del Registro de Artroplastias de Catalu&#241;a &#40;RACat&#41;&#58; exhaustividad&#44; variabilidad y supervivencia de las pr&#243;tesis entre 2005 y 2014"
        ]
      ]
      "contieneResumen" => array:2 [
        "en" => true
        "es" => true
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:7 [
          "identificador" => "fig0020"
          "etiqueta" => "Figure 4"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr4.jpeg"
              "Alto" => 1123
              "Ancho" => 1566
              "Tamanyo" => 89703
            ]
          ]
          "descripcion" => array:1 [
            "en" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Accumulated incidence of revision in hip arthroplasties caused by arthrosis and facture&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "J&#46; Arias-de la Torre, A&#46; Capdevila, O&#46; Mart&#237;nez, L&#46; Domingo, M&#46; Marinelli, N&#46; Robles, J&#46; Nardi, L&#46; Puig-Verdi&#233;, F&#46; Pallis&#243;, M&#46; Espallargues"
          "autores" => array:11 [
            0 => array:2 [
              "nombre" => "J&#46;"
              "apellidos" => "Arias-de la Torre"
            ]
            1 => array:2 [
              "nombre" => "A&#46;"
              "apellidos" => "Capdevila"
            ]
            2 => array:2 [
              "nombre" => "O&#46;"
              "apellidos" => "Mart&#237;nez"
            ]
            3 => array:2 [
              "nombre" => "L&#46;"
              "apellidos" => "Domingo"
            ]
            4 => array:2 [
              "nombre" => "M&#46;"
              "apellidos" => "Marinelli"
            ]
            5 => array:2 [
              "nombre" => "N&#46;"
              "apellidos" => "Robles"
            ]
            6 => array:2 [
              "nombre" => "J&#46;"
              "apellidos" => "Nardi"
            ]
            7 => array:2 [
              "nombre" => "L&#46;"
              "apellidos" => "Puig-Verdi&#233;"
            ]
            8 => array:2 [
              "nombre" => "F&#46;"
              "apellidos" => "Pallis&#243;"
            ]
            9 => array:2 [
              "nombre" => "M&#46;"
              "apellidos" => "Espallargues"
            ]
            10 => array:1 [
              "colaborador" => "en nombre del Registro de Artroplastias de Catalu&#241;a &#40;RACat&#41;"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "es" => array:9 [
        "pii" => "S1888441517300061"
        "doi" => "10.1016/j.recot.2017.01.001"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => false
          "ES2" => false
          "LATM" => false
        ]
        "gratuito" => false
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "es"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1888441517300061?idApp=UINPBA00004N"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1988885617300226?idApp=UINPBA00004N"
    "url" => "/19888856/0000006100000002/v1_201704050025/S1988885617300226/v1_201704050025/en/main.assets"
  ]
  "en" => array:21 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Original Article</span>"
    "titulo" => "Risk factors for local recurrence of fibromatosis"
    "tieneTextoCompleto" => true
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "82"
        "paginaFinal" => "87"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "V&#46; Machado, S&#46; Troncoso, L&#46; Mej&#237;as, M&#46;&#193;&#46; Idoate, M&#46; San-Juli&#225;n"
        "autores" => array:5 [
          0 => array:4 [
            "nombre" => "V&#46;"
            "apellidos" => "Machado"
            "email" => array:1 [
              0 => "vmachado&#64;unav&#46;es"
            ]
            "referencia" => array:2 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">&#42;</span>"
                "identificador" => "cor0005"
              ]
            ]
          ]
          1 => array:3 [
            "nombre" => "S&#46;"
            "apellidos" => "Troncoso"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          2 => array:3 [
            "nombre" => "L&#46;"
            "apellidos" => "Mej&#237;as"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
            ]
          ]
          3 => array:3 [
            "nombre" => "M&#46;&#193;&#46;"
            "apellidos" => "Idoate"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
            ]
          ]
          4 => array:3 [
            "nombre" => "M&#46;"
            "apellidos" => "San-Juli&#225;n"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
        ]
        "afiliaciones" => array:2 [
          0 => array:3 [
            "entidad" => "Departamento de Cirug&#237;a Ortop&#233;dica y Traumatolog&#237;a&#44; Cl&#237;nica Universidad de Navarra&#44; Pamplona&#44; Navarra&#44; Spain"
            "etiqueta" => "a"
            "identificador" => "aff0005"
          ]
          1 => array:3 [
            "entidad" => "Departamento de Anatom&#237;a Patol&#243;gica&#44; Cl&#237;nica Universidad de Navarra&#44; Pamplona&#44; Navarra&#44; Spain"
            "etiqueta" => "b"
            "identificador" => "aff0010"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Corresponding author&#46;"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "es" => array:1 [
        "titulo" => "Factores de riesgo para la recidiva local de la fibromatosis"
      ]
    ]
    "resumenGrafico" => array:2 [
      "original" => 0
      "multimedia" => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Figure 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 1892
            "Ancho" => 1625
            "Tamanyo" => 112751
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Anatomical distribution&#46;</p>"
        ]
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Fibromatosis&#44; or desmoid tumour&#44; is a clonal proliferation tumour deriving from mesenchymal cells seated in the fascia and musculoaponeurotic structures&#46; It constitutes a rare group of soft tissue tumours&#44; with an incidence of 2&#46;4&#8211;4&#46;3 new cases per 10<span class="elsevierStyleSup">6</span> inhabitants&#47;year&#46;<a class="elsevierStyleCrossRefs" href="#bib0075"><span class="elsevierStyleSup">1&#8211;3</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">For many years&#44; this tumour was treated by surgery fundamentally&#44; reserving chemotherapy&#44; radiotherapy and other systemic treatments such as tamoxifen or more recently&#44; imatinib or toremifine&#44;<a class="elsevierStyleCrossRefs" href="#bib0080"><span class="elsevierStyleSup">2&#44;4</span></a> for cases with positive surgical margins to improve local control of the disease&#46;<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">1</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">It can appear in practically any part of the body<a class="elsevierStyleCrossRefs" href="#bib0095"><span class="elsevierStyleSup">5&#44;6</span></a> and is locally aggressive&#44; with a high local recurrence rate&#44; despite broad surgical resection&#44; although it lacks the capacity for remote metastasis&#46;<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">2</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">Conservative management has been proposed recently as an acceptable treatment option&#44; since it is not unusual for the tumour to stop growing spontaneously&#46; This would prevent functional complications and post-radiation effects associated with the conventional&#44; radical management of fibromatosis&#46;<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">1</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">Because this is a rare entity&#44; the series available in the literature enable us to establish a consensus on some of the factors that influence the natural evolution of the disease&#46; It is our intention to evaluate the data that might predict local recurrence&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Methods</span><p id="par0030" class="elsevierStylePara elsevierViewall">We undertook a retrospective study identifying 192 patients with an anatomopathological diagnosis of fibromatosis in our institution from 1983 to 2014&#46; Patients with a clinical diagnosis of Dupuytren&#39;s&#44; Ledderhose disease or intra-abdominal desmoid tumour were excluded from the study&#44; because their prognosis is more favourable&#44; and patients with an unclear final diagnosis&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">The following variables were gathered from the patients included in the study&#58; age at the time of diagnosis&#44; gender&#44; imaging test type used in diagnosis&#44; location&#44; tumour size and depth&#44; relation to the vascular bundle&#44; initial treatment given&#44; primary tumour resection margins&#44; recurrences&#44; time until recurrence&#44; treatment and surgical margins&#44; and finally&#44; follow-up time and the patients&#8217; current condition and functional status according to the Musculoskeletal Tumour Society Score&#46; Due to the wide range of years over which our patients were diagnosed&#44; we also gathered the variations in the type of treatment through that time&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">All our cases were identified initially as primary or recurrences as they presented in our centre&#46; However&#44; this difference was not taken into account in the statistical analysis for classifying the primary tumours or recurrences&#44; or the subsequent determination of risk factors&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">The statistical analysis was then undertaken using the <span class="elsevierStyleItalic">&#967;</span><span class="elsevierStyleSup">2</span> test to assess the influence of patient gender&#44; age&#44; depth&#44; size&#44; location&#44; surgical margins and initial treatment on local recurrences&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">For this analysis&#44; in terms of age&#44; the patients aged &#8804;30 years were classified as &#8220;young&#8221; and those aged &#62;30 years as &#8220;older&#8221;&#46; Tumours that measured &#60;5<span class="elsevierStyleHsp" style=""></span>cm were classified as &#8220;small&#8221; and those that measured &#8805;5<span class="elsevierStyleHsp" style=""></span>cm as &#8220;large&#8221;&#44; in the same way as soft-tissue sarcomas&#46; Finally&#44; the tumour location was divided into 2 large groups&#58; extremities and trunk&#44; the latter included neck&#44; breast&#44; chest wall&#44; abdominal wall and paravertebrals&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">The initial treatment of our patients was evaluated&#46; Most underwent surgery as single therapy&#46; Some cases received adjuvant treatment as well as surgery&#44; such as radiotherapy&#44; chemotherapy and tamoxifen&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">The resection margins were classified according to Enneking&#39;s criteria&#46; In addition&#44; a revision of the histological preparations was made to quantify the Ki-67 of the histological blocks from 1992 onwards&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Results</span><p id="par0065" class="elsevierStylePara elsevierViewall">Our series includes 51 patients with a clinical and anatomopathological diagnosis of fibromatosis&#46; Twenty-nine of these patients were treated primarily in our centre&#44; and 22 presented as recurrences&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">The mean follow-up was 83 months &#40;range 6&#8211;240 months&#41;&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">The most common anatomical distribution was tumours located in the extremities &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>38&#41; compared to the trunk &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>13&#41; &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0080" class="elsevierStylePara elsevierViewall">The mean age at time of diagnosis was 26 years&#44; with a range from 2 to 68 years&#46; Distribution by gender showed a slight male predominance&#44; unlike the other published series&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">The mean size&#44; measured as the maximum tumour diameter&#44; was 9&#46;9<span class="elsevierStyleHsp" style=""></span>cm &#40;range 3&#8211;31<span class="elsevierStyleHsp" style=""></span>cm&#41;&#46; Most of the tumours were found deep in the fascia&#46; The imaging test used to study the tumours was initially ultrasound&#46; From 1990 onwards&#44; diagnosis was made by magnetic resonance&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">A complete macroscopic and microscopic &#40;R0&#41; resection was achieved in 11 patients&#46; The margins were microscopically positive &#40;R1&#41; in 16 patients&#44; and in 11 cases&#44; the resection was intentionally incomplete on entry &#40;R2&#41; due&#44; principally&#44; to the great morbidity resulting from radical surgery in certain locations such as the popliteal fossa&#44; groin and axilla&#46; We have no information on the outcomes of the resection margins of the primary tumour for 13 patients &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0095" class="elsevierStylePara elsevierViewall">In our patients&#44; the proliferation rate&#44; quantified using Ki-67&#44; was a mean 1&#46;9&#37; &#40;range 1&#8211;4&#41;&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">The total number of recurrences in our series was 37&#44; including incident cases &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>15&#41; plus those that presented as recurrences in our institution &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>22&#41;&#46; Out of these&#44; 22 presented new recurrences &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>7 and <span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>15&#44; respectively&#41;&#46; The incidence of &#8220;re-recurrence&#8221; was less in the cases treated primarily in our centre &#40;46&#46;7&#37; vs 68&#46;2&#37;&#41;&#44; although this difference is not statistically significant &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;443&#41;&#46; Neither are there statistically significant differences in re-recurrences according to the treatment of the first recurrence &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;112&#41;&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">The mean time between the primary resection and the first recurrence was 32 month &#40;range 2&#8211;420 months&#41;&#44; although recurrence within the first year &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>&#41; was most frequent&#46; The mean time until repeat recurrence is similar to that of the first &#40;mean 22&#46;56&#44; range 2&#8211;42&#41;&#46;</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0110" class="elsevierStylePara elsevierViewall">Due to the limited number of cases treated with adjuvant therapies&#44; no clear pattern for choosing this treatment was established&#46; However&#44; we did observe a variation over the years in terms of the type of radiotherapy&#46; Up until 1999&#44; patients who underwent radiotherapy received intraoperative radiotherapy complemented later with external radiotherapy&#44; whereas from 1999 onwards brachytherapy plus external radiotherapy was used&#46; In both groups&#44; the mean dose received was 45<span class="elsevierStyleHsp" style=""></span>Gy&#44; and in no case did this exceed 60<span class="elsevierStyleHsp" style=""></span>Gy&#46;</p><p id="par0115" class="elsevierStylePara elsevierViewall">We saw no homogeneity in terms of chemotherapy protocol either &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0120" class="elsevierStylePara elsevierViewall">Twenty-seven patients are currently disease-free&#44; 8 are in the progression phase&#44; 15 are in stable disease phase&#44; and for one patient we have no information&#46;</p><p id="par0125" class="elsevierStylePara elsevierViewall">We observed no statistically significant differences in our series with regard to gender&#44; age&#44; size&#44; margins or initial treatment as risk factors for local recurrence&#46; By contrast&#44; we did observe a greater risk of local recurrence in patients presenting tumours deep in the fascia &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;003&#41; and tumours located in the extremities &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;0001&#41; &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0130" class="elsevierStylePara elsevierViewall">The Musculoskeletal Tumour Society Score showed no statistically significant differences either &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;19&#41; between the patients treated with surgery alone compared to those treated with surgery plus radiotherapy and those who underwent follow-up with periodic monitoring&#46; Other complications after surgery included lymphoedema &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>2&#41; and paralysis of the peroneal nerve &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#41;&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Discussion</span><p id="par0135" class="elsevierStylePara elsevierViewall">In most current studies&#44; positive surgical margins are considered a risk factor of local recurrence&#59; however&#44; there is no universal consensus on the matter&#46;<a class="elsevierStyleCrossRefs" href="#bib0085"><span class="elsevierStyleSup">3&#44;6&#8211;8</span></a> In our case&#44; we found no statistically significant differences in this parameter&#46;</p><p id="par0140" class="elsevierStylePara elsevierViewall">Although there is no unanimity in this regard&#44; the negative effect of incomplete surgery with positive margins &#40;R1&#44; R2&#41; on local recurrence of the disease has a strong biological basis&#46;<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">9</span></a> Up to 75&#37; of desmoid tumours present mutations associated with &#946;-catenin&#46; Most are sporadic&#44; although a small percentage is associated with APC gene mutations&#44; in Gardner syndrome&#46;<a class="elsevierStyleCrossRefs" href="#bib0075"><span class="elsevierStyleSup">1&#44;10&#44;11</span></a></p><p id="par0145" class="elsevierStylePara elsevierViewall">In the initial phase of wound healing&#44; growth factors are released that activate &#946;-catenin&#46; This protein plays an important role in healing&#44; since it stimulates the proliferation of fibroblasts&#44; and therefore is also important in fibroproliferative disorders&#46; Incomplete resection of a tumour involves leaving genetically altered cells in the bed exposed to the healing mechanisms of the tissues&#46; Thus&#44; surgery itself acts as a cancer potentiator in cases where there is a beta-catenin aberration&#46;</p><p id="par0150" class="elsevierStylePara elsevierViewall">Various mutations have been identified in the CTNNB1 gene&#44; responsible for coding &#946;-catenin&#46; The mutations of this gene that are associated with fibromatosis are T41A&#44; S45F and 45P&#44; but S45F is the only one of prognostic value as a predictor of local recurrence&#46;<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">12</span></a> These variations in &#946;-catenin mutations can in part explain the differences in the development of recurrences in relation to surgical margins&#46;<a class="elsevierStyleCrossRefs" href="#bib0075"><span class="elsevierStyleSup">1&#44;8&#44;12</span></a></p><p id="par0155" class="elsevierStylePara elsevierViewall">As we have seen to date&#44; the evolution of this tumour is unpredictable&#44; up to a certain point&#46; In many cases&#44; there is a high tendency for local recurrence despite apparently complete resection&#46; Furthermore&#44; some studies support the fact that adjuvant therapies can be effective in controlling the disease&#46; However&#44; there is no consensus in this regard&#44; since there are desmoid tumours that have been observed to stop growing spontaneously&#46;<a class="elsevierStyleCrossRefs" href="#bib0085"><span class="elsevierStyleSup">3&#44;7&#44;13&#44;14</span></a> It does appear clear that as we increase therapeutic measures&#44; in addition to increasing monitoring of the disease&#44; we enhance the functional consequences&#44; those of radical surgery and radiotherapy in particular&#46;<a class="elsevierStyleCrossRefs" href="#bib0135"><span class="elsevierStyleSup">13&#44;14</span></a></p><p id="par0160" class="elsevierStylePara elsevierViewall">We must remember&#44; in our series&#44; that treatment by periodic monitoring only took place in patients who had already developed local recurrence&#44; therefore we do not know what would have happened if we had not operated the primary tumours&#46;</p><p id="par0165" class="elsevierStylePara elsevierViewall">In high grade tumours&#44; when we observe multiple recurrences&#44; the disease-free time between each recurrence progressively shortens&#46; In desmoid tumours&#44; recurrences do not follow this pattern&#46; As we saw in our series&#44; the recurrences&#44; both primary and secondary&#44; occurred most frequently during the first year&#44; without the disease-free time between the first and the second recurrence being significantly shortened&#46;</p><p id="par0170" class="elsevierStylePara elsevierViewall">Due to the lack of evidence in our series on the efficacy of the various treatments on local control of the disease&#44; we cannot actively recommend the use of radiotherapy&#44; chemotherapy or tamoxifen as adjuvant treatment&#46;</p><p id="par0175" class="elsevierStylePara elsevierViewall">It was observed that in selected cases&#44; where the tumour was asymptomatic and did not display aggressive behaviour throughout follow-up&#44; conservative treatment by periodic monitoring achieved local control of the disease at 3 years similar to that of the patients who underwent complete resection &#40;R0&#41;&#46;<a class="elsevierStyleCrossRefs" href="#bib0075"><span class="elsevierStyleSup">1&#44;3&#44;7</span></a></p><p id="par0180" class="elsevierStylePara elsevierViewall">Due to the high rate of local recurrence and the morbidity after multiple surgeries&#44; a wait-and-see approach should be considered for all desmoid tumours&#44; primary or recurrences&#44; which are asymptomatic and have not grown throughout their evolution&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Level of evidence</span><p id="par0185" class="elsevierStylePara elsevierViewall">Level of evidence <span class="elsevierStyleSmallCaps">III</span>&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Ethical disclosures</span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Protection of people and animals</span><p id="par0190" class="elsevierStylePara elsevierViewall">The authors declare that no experiments were performed on humans or animals for this study&#46;</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Confidentiality of data</span><p id="par0195" class="elsevierStylePara elsevierViewall">The authors declare that they have followed the protocols of their centre of work regarding the publication of patient data&#46;</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Right to privacy and informed consent</span><p id="par0200" class="elsevierStylePara elsevierViewall">The authors declare that no patient data appear in this article&#46;</p></span></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Conflict of interests</span><p id="par0205" class="elsevierStylePara elsevierViewall">The authors have no conflict of interests to declare&#46;</p></span></span>"
    "textoCompletoSecciones" => array:1 [
      "secciones" => array:13 [
        0 => array:3 [
          "identificador" => "xres824432"
          "titulo" => "Abstract"
          "secciones" => array:4 [
            0 => array:2 [
              "identificador" => "abst0005"
              "titulo" => "Objective"
            ]
            1 => array:2 [
              "identificador" => "abst0010"
              "titulo" => "Methods"
            ]
            2 => array:2 [
              "identificador" => "abst0015"
              "titulo" => "Results"
            ]
            3 => array:2 [
              "identificador" => "abst0020"
              "titulo" => "Discussion"
            ]
          ]
        ]
        1 => array:2 [
          "identificador" => "xpalclavsec820938"
          "titulo" => "Keywords"
        ]
        2 => array:3 [
          "identificador" => "xres824433"
          "titulo" => "Resumen"
          "secciones" => array:4 [
            0 => array:2 [
              "identificador" => "abst0025"
              "titulo" => "Objetivo"
            ]
            1 => array:2 [
              "identificador" => "abst0030"
              "titulo" => "M&#233;todos"
            ]
            2 => array:2 [
              "identificador" => "abst0035"
              "titulo" => "Resultados"
            ]
            3 => array:2 [
              "identificador" => "abst0040"
              "titulo" => "Discusi&#243;n"
            ]
          ]
        ]
        3 => array:2 [
          "identificador" => "xpalclavsec820937"
          "titulo" => "Palabras clave"
        ]
        4 => array:2 [
          "identificador" => "sec0005"
          "titulo" => "Introduction"
        ]
        5 => array:2 [
          "identificador" => "sec0010"
          "titulo" => "Methods"
        ]
        6 => array:2 [
          "identificador" => "sec0015"
          "titulo" => "Results"
        ]
        7 => array:2 [
          "identificador" => "sec0020"
          "titulo" => "Discussion"
        ]
        8 => array:2 [
          "identificador" => "sec0025"
          "titulo" => "Level of evidence"
        ]
        9 => array:3 [
          "identificador" => "sec0030"
          "titulo" => "Ethical disclosures"
          "secciones" => array:3 [
            0 => array:2 [
              "identificador" => "sec0035"
              "titulo" => "Protection of people and animals"
            ]
            1 => array:2 [
              "identificador" => "sec0040"
              "titulo" => "Confidentiality of data"
            ]
            2 => array:2 [
              "identificador" => "sec0045"
              "titulo" => "Right to privacy and informed consent"
            ]
          ]
        ]
        10 => array:2 [
          "identificador" => "sec0050"
          "titulo" => "Conflict of interests"
        ]
        11 => array:2 [
          "identificador" => "xack276488"
          "titulo" => "Acknowledgements"
        ]
        12 => array:1 [
          "titulo" => "References"
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2016-06-02"
    "fechaAceptado" => "2016-12-10"
    "PalabrasClave" => array:2 [
      "en" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Keywords"
          "identificador" => "xpalclavsec820938"
          "palabras" => array:4 [
            0 => "Fibromatosis"
            1 => "Desmoid tumour"
            2 => "Local recurrence"
            3 => "Risk factors"
          ]
        ]
      ]
      "es" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Palabras clave"
          "identificador" => "xpalclavsec820937"
          "palabras" => array:4 [
            0 => "Fibromatosis"
            1 => "Tumor desmoide"
            2 => "Recidiva local"
            3 => "Factores de riesgo"
          ]
        ]
      ]
    ]
    "tieneResumen" => true
    "resumen" => array:2 [
      "en" => array:3 [
        "titulo" => "Abstract"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Objective</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">To evaluate the clinical&#44; radiological and histological factors that can predict local recurrence of fibromatosis&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">A retrospective study was conducted on 51 patients diagnosed with fibromatosis in this hospital from 1983 to 2014&#46; The mean follow-up was 83 months&#46; A study was made of the clinical parameters&#44; location&#44; depth&#44; size&#44; surgical margins&#44; and proliferation index &#40;Ki-67&#41;&#46; An evaluation was also made of the risk of recurrence depending on the adjuvant treatment and the relationship between treatment and patient functionality&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Tumour location and depth were identified as risk factors for local recurrence&#44; showing statistically significant differences &#40;<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;001 and <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;003&#44; respectively&#41;&#46; There were no statistically significant differences in age&#44; gender&#44; size&#44; surgical margins&#44; or adjuvant treatments&#44; or in the Musculoskeletal Tumour Society Score according to the treatment received&#46; The mean Ki-67 was 1&#46;9&#37; &#40;range 1&#8211;4&#41;&#44; and its value was not associated with the risk of recurrence&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Discussion</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Deep fibromatosis fascia tumours&#44; and those located in extremities are more aggressive than superficial tumours and those located in trunk&#46; The Ki-67 has no predictive value in local recurrence of fibromatosis&#46; Radiotherapy&#44; chemotherapy&#44; or other adjuvant treatments such as tamoxifen have not been effective in local control of the disease&#46; Given the high recurrence rate&#44; even with adequate margins&#44; a wait and see attitude should be considered in asymptomatic patients and&#47;or stable disease&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "abst0005"
            "titulo" => "Objective"
          ]
          1 => array:2 [
            "identificador" => "abst0010"
            "titulo" => "Methods"
          ]
          2 => array:2 [
            "identificador" => "abst0015"
            "titulo" => "Results"
          ]
          3 => array:2 [
            "identificador" => "abst0020"
            "titulo" => "Discussion"
          ]
        ]
      ]
      "es" => array:3 [
        "titulo" => "Resumen"
        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Objetivo</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Valorar los factores cl&#237;nicos&#44; radiol&#243;gicos e histol&#243;gicos que pueden predecir la recidiva local de fibromatosis&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">M&#233;todos</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Hemos realizado un estudio retrospectivo de 51 pacientes con diagn&#243;stico de fibromatosis en nuestra instituci&#243;n desde 1983 hasta 2014&#46; La media de seguimiento es de 83 meses&#46; Hemos estudiado par&#225;metros cl&#237;nicos&#44; localizaci&#243;n&#44; profundidad&#44; tama&#241;o&#44; m&#225;rgenes quir&#250;rgicos e &#237;ndice de proliferaci&#243;n &#40;Ki-67&#41; del tumor&#46; Asimismo&#44; hemos valorado el riesgo de recidiva en funci&#243;n del tratamiento adyuvante y la relaci&#243;n del tratamiento con la funcionalidad del paciente&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Hemos observado diferencias estad&#237;sticamente significativas en cuanto a la profundidad &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;003&#41; y la localizaci&#243;n &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41; como factores de riesgo de recidiva local&#46; No existen diferencias estad&#237;sticamente significativas en cuanto a edad&#44; sexo&#44; tama&#241;o&#44; m&#225;rgenes quir&#250;rgicos ni tratamientos adyuvantes&#44; ni en el Musculoskeletal Tumor Society Score en funci&#243;n del tratamiento recibido&#46; El Ki-67 tiene una media de 1&#44;9&#37; &#40;rango 1-4&#41; y su valor no se asocia con el riesgo de recidiva&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Discusi&#243;n</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Los tumores profundos a la fascia y los localizados en extremidades son m&#225;s agresivos que los localizados superficialmente y en el tronco&#46; El Ki-67 no tiene valor predictivo en las recidivas de la fibromatosis&#46; La radioterapia&#44; la quimioterapia u otros tratamientos adyuvantes como el tamoxifeno no han sido eficaces en el control local de la enfermedad&#46; La gran cantidad de recidivas&#44; incluso en pacientes con resecciones adecuadas&#44; induce a plantear la posibilidad de una actitud expectante en tumores asintom&#225;ticos o en enfermedad estable&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "abst0025"
            "titulo" => "Objetivo"
          ]
          1 => array:2 [
            "identificador" => "abst0030"
            "titulo" => "M&#233;todos"
          ]
          2 => array:2 [
            "identificador" => "abst0035"
            "titulo" => "Resultados"
          ]
          3 => array:2 [
            "identificador" => "abst0040"
            "titulo" => "Discusi&#243;n"
          ]
        ]
      ]
    ]
    "NotaPie" => array:1 [
      0 => array:2 [
        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as&#58; Machado V&#44; Troncoso S&#44; Mej&#237;as L&#44; Idoate M&#193;&#44; San-Juli&#225;n M&#46; Factores de riesgo para la recidiva local de la fibromatosis&#46; Rev Esp Cir Ortop Traumatol&#46; 2017&#59;61&#58;82&#8211;87&#46;</p>"
      ]
    ]
    "multimedia" => array:5 [
      0 => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Figure 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 1892
            "Ancho" => 1625
            "Tamanyo" => 112751
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Anatomical distribution&#46;</p>"
        ]
      ]
      1 => array:7 [
        "identificador" => "fig0010"
        "etiqueta" => "Figure 2"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr2.jpeg"
            "Alto" => 1846
            "Ancho" => 1583
            "Tamanyo" => 67905
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Time since first local recurrence&#46;</p>"
        ]
      ]
      2 => array:8 [
        "identificador" => "tbl0005"
        "etiqueta" => "Table 1"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at1"
            "detalle" => "Table "
            "rol" => "short"
          ]
        ]
        "tabla" => array:2 [
          "leyenda" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">NA&#58; not available&#59; CT&#58; chemotherapy&#59; RT&#58; radiotherapy&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">n</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " colspan="3" align="left" valign="top"><span class="elsevierStyleItalic">Gender</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Male&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">28&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">45&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Female&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">23&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">54&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="3" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="3" align="left" valign="top"><span class="elsevierStyleItalic">Depth</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Superficial&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">17&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Deep&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">41&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">80&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>NA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="3" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="3" align="left" valign="top"><span class="elsevierStyleItalic">Size</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>&#60;5<span class="elsevierStyleHsp" style=""></span>cm&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7&#46;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>&#8805;5<span class="elsevierStyleHsp" style=""></span>cm&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">47&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">92&#46;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="3" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="3" align="left" valign="top"><span class="elsevierStyleItalic">Relation with vascular bundle</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">17&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">17&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">33&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>NA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">25&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">49&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="3" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="3" align="left" valign="top"><span class="elsevierStyleItalic">Treatment of primary tumour</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Surgery&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">40&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">78&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Surgery<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>RT&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">17&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Surgery<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>CT&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Surgery<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>RT<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>tamoxifen&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="3" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="3" align="left" valign="top"><span class="elsevierStyleItalic">Primary resection margins</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>R0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">11&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">21&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>R1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">16&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">31&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>R2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">11&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">21&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>NA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">13&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">25&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="3" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="3" align="left" valign="top"><span class="elsevierStyleItalic">Local recurrence</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">13&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">25&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">37&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">72&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>NA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab1386111.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Characteristics of the patients with fibromatosis and of the primary tumour&#46;</p>"
        ]
      ]
      3 => array:8 [
        "identificador" => "tbl0010"
        "etiqueta" => "Table 2"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at2"
            "detalle" => "Table "
            "rol" => "short"
          ]
        ]
        "tabla" => array:2 [
          "leyenda" => "<p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">VAC&#58; vincristine<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>doxorubicin<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>cyclophosphamide&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Patient&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Protocol&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Year&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Case 8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">VAC<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>methotrexate<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>ribervin<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>etoposide&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1991&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Case 14&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Vincristine<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>actinomycin D<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>cyclophosphamide&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2004&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Case 28&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Adriamycin<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>cisplatin&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2008&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Case 32&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Imatinib&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2008&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Case 33&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Bevacizumab&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2007&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab1386112.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Protocols of chemotherapy administered&#46;</p>"
        ]
      ]
      4 => array:8 [
        "identificador" => "tbl0015"
        "etiqueta" => "Table 3"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at3"
            "detalle" => "Table "
            "rol" => "short"
          ]
        ]
        "tabla" => array:2 [
          "leyenda" => "<p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">The statistically significant <span class="elsevierStyleItalic">p</span> value results are in bold&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">&#967;</span><span class="elsevierStyleSup">2</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">p</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Gender&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;84&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;66&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Age&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#46;37&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;31&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Depth&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">9&#46;11&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top"><span class="elsevierStyleBold">0&#46;003</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Size&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;30&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;25&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Location&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">16&#46;01&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top"><span class="elsevierStyleBold">&#60;0&#46;001</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Margins&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">12&#46;14&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;059&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Initial treatment&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#46;51&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;86&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab1386113.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">Risk factors for local recurrence&#46;</p>"
        ]
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0005"
          "bibliografiaReferencia" => array:14 [
            0 => array:3 [
              "identificador" => "bib0075"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Extra-abdominal primary fibromatosis&#58; aggressive management could be avoided in a subgroup of patients"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "S&#46; Bonvalot"
                            1 => "H&#46; Eldweny"
                            2 => "V&#46; Haddad"
                            3 => "F&#46; Rimareix"
                            4 => "G&#46; Missernad"
                            5 => "O&#46; Oberlin"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.ejso.2007.06.006"
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur J Surg Oncol"
                        "fecha" => "2008"
                        "volumen" => "34"
                        "paginaInicial" => "462"
                        "paginaFinal" => "468"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17709227"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0080"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Management of sporadic desmoid-type fibromatosis&#58; a European consensus approach based on patients&#8217; and professionals&#8217; expertise &#8211; a Sarcoma Patients EuroNet and European Organisation for Research and Treatment of Cancer&#47;Soft Tissue and Bone Sarcoma Group initiative"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "B&#46; Kasper"
                            1 => "C&#46; Baumgarten"
                            2 => "S&#46; Bonvalot"
                            3 => "R&#46; Haas"
                            4 => "F&#46; Haller"
                            5 => "P&#46; Hohenberger"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.ejca.2014.11.005"
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur J Cancer"
                        "fecha" => "2015"
                        "volumen" => "51"
                        "paginaInicial" => "127"
                        "paginaFinal" => "136"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25434922"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0085"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Prognostic factors influencing event-free survival and treatments in desmoid-type fibromatosis&#58; analysis from a large institution"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "K&#46; Huang"
                            1 => "C&#46; Wang"
                            2 => "J&#46; Chen"
                            3 => "C&#46;Y&#46; Du"
                            4 => "Y&#46; Zhou"
                            5 => "Y&#46; Shi"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.amjsurg.2013.08.007"
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Surg"
                        "fecha" => "2014"
                        "volumen" => "207"
                        "paginaInicial" => "847"
                        "paginaFinal" => "854"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24119719"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0090"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Hormonal manipulation with toremifene in sporadic desmoid-type fibromatosis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46; Fiore"
                            1 => "C&#46; Colombo"
                            2 => "S&#46; Radaelli"
                            3 => "D&#46; Callegaro"
                            4 => "E&#46; Palassini"
                            5 => "M&#46; Barisella"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.ejca.2015.08.026"
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur J Cancer"
                        "fecha" => "2015"
                        "volumen" => "51"
                        "paginaInicial" => "2800"
                        "paginaFinal" => "2807"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26602014"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0095"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Local recurrence after surgery for primary extra-abdominal desmoid-type fibromatosis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "D&#46;L&#46; Van Broekhoven"
                            1 => "C&#46; Verhoef"
                            2 => "S&#46;G&#46; Elias"
                            3 => "A&#46;J&#46; Witkamp"
                            4 => "J&#46;M&#46; van Gorp"
                            5 => "B&#46;A&#46; van Geel"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1002/bjs.9194"
                      "Revista" => array:6 [
                        "tituloSerie" => "Br J Surg"
                        "fecha" => "2013"
                        "volumen" => "100"
                        "paginaInicial" => "1214"
                        "paginaFinal" => "1219"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23804156"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0100"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Desmoid tumor&#58; analysis of prognostic factors and outcomes in a surgical series"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "J&#46;T&#46; Mullen"
                            1 => "T&#46;F&#46; DeLaney"
                            2 => "W&#46;K&#46; Kobayashi"
                            3 => "J&#46; Szymonifka"
                            4 => "B&#46;Y&#46; Yeap"
                            5 => "Y&#46;L&#46; Chen"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1245/s10434-012-2638-2"
                      "Revista" => array:6 [
                        "tituloSerie" => "Ann Surg Oncol"
                        "fecha" => "2012"
                        "volumen" => "19"
                        "paginaInicial" => "4028"
                        "paginaFinal" => "4035"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22965569"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib0105"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Recurrence and prognostic factors in patients with aggressive fibromatosis&#46; The role of radical surgery and its limitations"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "E&#46; Bertani"
                            1 => "A&#46; Testori"
                            2 => "A&#46; Chiappa"
                            3 => "P&#46; Misitano"
                            4 => "R&#46; Biffi"
                            5 => "G&#46; Viale"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1186/1477-7819-10-184"
                      "Revista" => array:5 [
                        "tituloSerie" => "World J Surg Oncol"
                        "fecha" => "2012"
                        "volumen" => "10"
                        "paginaInicial" => "184"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22963172"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib0110"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Actualisation de la strat&#233;gie th&#233;rapeutique locor&#233;gionale dans les sarcomes des tissus mous et les tumeurs desmoids des membres"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "S&#46; Bonvalot"
                            1 => "F&#46; Rimareix"
                            2 => "A&#46; Paumier"
                            3 => "E&#46; Roberti"
                            4 => "H&#46; Bouzaiene"
                            5 => "C&#46; Le P&#233;choux"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.canrad.2010.06.016"
                      "Revista" => array:6 [
                        "tituloSerie" => "Cancer Radiother"
                        "fecha" => "2010"
                        "volumen" => "14"
                        "paginaInicial" => "455"
                        "paginaFinal" => "459"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20797892"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib0115"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "&#946;-Catenin mutation status and outcomes in sporadic desmoid tumors"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "J&#46; Mullen"
                            1 => "T&#46; Delaney"
                            2 => "A&#46; Rosenberg"
                            3 => "L&#46; Le"
                            4 => "J&#46; Iafrate"
                            5 => "W&#46; Kobayashi"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1634/theoncologist.2012-0449"
                      "Revista" => array:6 [
                        "tituloSerie" => "Oncologist"
                        "fecha" => "2013"
                        "volumen" => "18"
                        "paginaInicial" => "1043"
                        "paginaFinal" => "1049"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23960186"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib0120"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A prognostic nomogram for prediction of recurrence in desmoid fibromatosis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "A&#46;M&#46; Crago"
                            1 => "B&#46; Denton"
                            2 => "S&#46; Salas"
                            3 => "A&#46; Dufresne"
                            4 => "J&#46;J&#46; Mezhir"
                            5 => "M&#46; Hameed"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1097/SLA.0b013e31828c8a30"
                      "Revista" => array:6 [
                        "tituloSerie" => "Ann Surg"
                        "fecha" => "2013"
                        "volumen" => "258"
                        "paginaInicial" => "347"
                        "paginaFinal" => "353"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23532110"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib0125"
              "etiqueta" => "11"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Desmoid-type fibromatosis-associated gardner fibromas&#58; prevalence and impact on local recurrence"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "J&#46; Cates"
                            1 => "T&#46; Stricker"
                            2 => "D&#46; Sturgeon"
                            3 => "C&#46; Coffin"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.canlet.2014.07.020"
                      "Revista" => array:6 [
                        "tituloSerie" => "Cancer Lett"
                        "fecha" => "2014"
                        "volumen" => "353"
                        "paginaInicial" => "176"
                        "paginaFinal" => "181"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25064609"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib0130"
              "etiqueta" => "12"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Prognostic value of CTNNB1 gene mutation in primary sporadic aggressive fibromatosis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "D&#46;L&#46; Van Broekhoven"
                            1 => "C&#46; Verhoef"
                            2 => "D&#46; Gr&#252;nhagen"
                            3 => "J&#46; van Gorp"
                            4 => "M&#46; den Bakker"
                            5 => "J&#46; Hinrichs"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1245/s10434-014-4156-x"
                      "Revista" => array:6 [
                        "tituloSerie" => "Ann Surg Oncol"
                        "fecha" => "2014"
                        "volumen" => "22"
                        "paginaInicial" => "1464"
                        "paginaFinal" => "1470"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25341748"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib0135"
              "etiqueta" => "13"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Surgical resection and radiation therapy of desmoid tumours of the extremities&#58; results of a supra-regional tumour centre"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "P&#46; Prodinger"
                            1 => "H&#46; Rechl"
                            2 => "M&#46; Keller"
                            3 => "H&#46; Pilge"
                            4 => "M&#46; Salzmann"
                            5 => "R&#46; von Eisenhart-Rothe"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "SICOT J"
                        "fecha" => "2013"
                        "volumen" => "37"
                        "paginaInicial" => "1987"
                        "paginaFinal" => "1993"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib0140"
              "etiqueta" => "14"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The desmoid tumour&#58; local control after surgical treatment"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "H&#46;R&#46; Ihalainen"
                            1 => "V&#46; Koljonen"
                            2 => "T&#46;O&#46; B&#246;hling"
                            3 => "E&#46;J&#46; Tukiainen"
                            4 => "M&#46;M&#46; Sampo"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3109/2000656X.2014.920710"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Plast Surg Hand Surg"
                        "fecha" => "2015"
                        "volumen" => "49"
                        "paginaInicial" => "19"
                        "paginaFinal" => "24"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25116575"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
    "agradecimientos" => array:1 [
      0 => array:4 [
        "identificador" => "xack276488"
        "titulo" => "Acknowledgements"
        "texto" => "<p id="par0210" class="elsevierStylePara elsevierViewall">To Dr&#46; Juan Pons de Villanueva and Dr&#46; D&#225;maso Aquerreta&#46;</p>"
        "vista" => "all"
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/19888856/0000006100000002/v1_201704050025/S1988885617300238/v1_201704050025/en/main.assets"
  "Apartado" => array:4 [
    "identificador" => "7577"
    "tipo" => "SECCION"
    "en" => array:2 [
      "titulo" => "Original articles"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "en"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/19888856/0000006100000002/v1_201704050025/S1988885617300238/v1_201704050025/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1988885617300238?idApp=UINPBA00004N"
]

Article information

ISSN: 19888856
Original language: English

DOI:10.1016/j.recote.2017.02.006

The statistics are updated each day

Year/Month	Html	Pdf	Total

2024 November	7	0	7
2024 October	11	1	12
2024 September	22	5	27
2024 August	26	5	31
2024 July	23	5	28
2024 June	25	0	25
2024 May	23	2	25
2024 April	56	6	62
2024 March	36	7	43
2024 February	19	5	24
2024 January	40	7	47
2023 December	27	9	36
2023 November	15	3	18
2023 October	20	8	28
2023 September	17	5	22
2023 August	25	2	27
2023 July	14	6	20
2023 June	25	4	29
2023 May	38	3	41
2023 April	21	4	25
2023 March	10	1	11
2023 February	20	2	22
2023 January	39	7	46
2022 December	56	6	62
2022 November	34	4	38
2022 October	30	3	33
2022 September	24	12	36
2022 August	41	10	51
2022 July	24	5	29
2022 June	16	7	23
2022 May	11	5	16
2022 April	20	9	29
2022 March	31	8	39
2022 February	14	4	18
2022 January	18	5	23
2021 December	13	12	25
2021 November	16	9	25
2021 October	18	7	25
2021 September	18	7	25
2021 August	12	10	22
2021 July	12	7	19
2021 June	11	6	17
2021 May	16	5	21
2021 April	30	19	49
2021 March	25	14	39
2021 February	11	10	21
2021 January	12	5	17
2020 December	1	3	4
2019 July	1	2	3
2019 May	1	2	3
2017 September	1	0	1

Show all

Indexed in:

Follow us:

Statistics

Indexed in:

Follow us:

Statistics

Subscribe to our newsletter